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Olivia Riutta Commentary: “Medicaid Expansion is Good for Montana”

While team USA has been busy swimming, vaulting, and diving to gold, Montana Women Vote has been celebrating another victory here, stateside. And we have quite a cheering section – to the tune of 47 million.

On August 1st a key piece of the Affordable Care Act, health care reform, went into effect and with it, 47 million women will gain access to no-cost preventive health services, 140,000 of these women are here in Montana.

This is the care that allows us to stay healthy:
• Diabetes screenings;
• Well-women visits;
• HIV screening and counseling;
• Domestic violence screening;
• Breastfeeding support, services, and supplies; and
• And the full range of FDA approved contraceptives and contraceptive counseling, and the list goes on.
And women are cheering! This is a victory for women’s health and a key piece of health reform has finally come to fruition. It also just makes sense, invest in these preventive health services, keep people healthy, detect problems early, we save money, not to mention it improves women’s lives. Win and win.
So while it is important to celebrate our wins, it is also essential to start talking the next steps in getting uninsured Americans covered. Step one: expand the Medicaid program here in Montana and make sure that our most vulnerable neighbors get access to care.

As you may remember, the US Supreme Court ruled last month on the Affordable Care Act, and for the most part it was upheld, except for part of the Medicaid expansion.
So the Affordable Care Act will reduce the number of people without health insurance in two ways: by providing tax credits that make insurance more affordable for people buying coverage on their own, through new health insurance Exchanges. And by expanding Medicaid.
Almost half of the nation’s uninsured could qualify for Medicaid under the ACA. These are folks who have incomes under 138% of the federal poverty level, which is about $15,000 for an individual and $25,500 for a family of three.
The health care law planned to achieve this expansion with both a carrot and a stick. The stick: if states didn’t expand their Medicaid program, they would lose all of their existing federal Medicaid dollars. This stick part, this is what The Supreme Court rejected and the decision to expand Medicaid was handed over to the states.
But let’s not forget about the carrot: Medicaid is a fed-state program, right now in Montana we pay about 1/3 of the cost and the feds kick in the other 2/3rds.

Under the ACA, the first three years of state expansion are fully covered with federal funds, with states ultimately picking up about 10% of the tab over time. That is not just any carrot, that is a sweet, homegrown, best carrot you’ve ever had- carrot.

So Montana, we are faced with a choice, an opportunity, to invest in the health and well being of our state, a change to ensure that 73,000 Montanans, primarily adults, can get health care.
Last month, the New England Journal of Medicine came out with a study that looked at states that have already expanded their Medicaid program for adults, which is the expansion we would see here. They wanted to see if Medicaid translated into better health outcome.
And for the record, this is a claim that Medicaid opponents will make, that the program is so flawed that it hurts people more than it helps.
Well, according to this study, which was conducted by Harvard researchers, Medicaid translated to less delayed care, healthier people, and better health also translated in more economic stability. Which makes sense: you can’t go to work if you are sick and paying for health care without insurance is super costly. The study also concluded that in states that have expanded their programs, those on Medicaid had a lower mortality rate – fewer people died.
And if saving lives wasn’t enough, it makes financial sense. It helps the economic stability of families and individuals and the expansion of Medicaid translates into a huge investment in our state and local economies.

Now is probably a good the time to also remind us that health reform, Obamacare, actually saves us money, thru both the exchanges and expansion of Medicaid. It reduced the federal deficit and people get access to health care, what a deal.
So, the decision to expand Medicaid is in our court. It is a choice that we must make in the 2013 legislative session. And Montana can’t afford to let divisive politics stand in the way. Expansion of Medicaid is a critical step in getting uninsured Montanans access to health insurance and care. It is an economic boom for families and communities. It is a win – win for Montana.